Specimen:

Serum

Collection Medium:

Minimum:

Adult - 5 ml; red top tube
Pediatric - 2 ml; red top tube

Testing
Schedule:

Daily - Batch analysis performed daily excluding 
weekends and university holidays.

Analytic Time:

3 days

Reference Range:

<1:40 Titer, includes interpretative report.

Comments:

Please include relevant clinical information on test order form.

Test includes both C-ANCA and P-ANCA screening.  Anti-neutrophil 
cytoplasmic antibodies are associated primarily with two groups of 
diseases: systemic necrotizing vasculitis/glomerulonephritis and 
inflammatory bowel and liver disease.  Because the laboratory testing  
strategies are different for these two groups of disease, different 
tests must be ordered for each of these workups.  "ANCA" is the test to 
be ordered when vasculitis/glomerulonephritis is in the differential 
diagnosis.  "UC-ANCA" is the test to order to evaluate patients with 
suspected inflammatory bowel or liver disease (see UC-ANCA listing for 
more testing information).

The "ANCA" test starts with immunofluorescence screening for both 
C-ANCA (primarily associated with Wegner's granulomatosis) and p-ANCA 
(primarily associated with microscopic polyarteritis and pauci-immune 
GN). If the ANCA screen is positive, titration to end-point is 
performed. It is strongly recommended that confirmatory testing for 
anti-proteinase 3 (PR3) and anti-myeloperoxidase (MPO) be performed at 
the time of initial identification of ANCA. P-ANCA can be confused with 
"UC-ANCA" or ANA on IFA screening.  Approximately 5% of patients with 
either "C-ANCA" or "P-ANCA" will have a specificity different from that 
usually associated with the ANCA IFA pattern (eg: P-ANCA may have PR3 
specificity and the C-ANCA may have MPO specificity.

Titer performed only if screen is positive.

Methodology:

Immunofluorescence

Sample
Processing:

Centrifuge at 3500 RPM for 5 minutes.
Aliquot serum into labeled container and cap.
Relevant clinical information must be submitted with specimen in order 
to provide correct interpretation of test results.

Sample
Storage:

Refrigerate serum 2-8 degree C.

Transport
Instructions:

Place specimen into zip-lock type bag, seal bag.
Place requisition into outside pocket of bag.
Ship at ambient temperature.

CPT Code:

86255 ANCA Screen, 86255-26 ANCA Screen Professional Interpretation, 
86256 ANCA Titer, 86256-26 ANCA Titer Professional Interpretation

See also:
Myeloperoxidase Antibody, Serum
Proteinase 3 Antibody, Serum